Periodontal (gum) disease is an infectious disease that progressively weakens the attachment of supporting tissues to the teeth, including gums, ligaments and bone. If not stopped, the loss of attachment will eventually lead to bone and tooth loss.

A thin layer of plaque that builds up on teeth (mainly due to poor oral hygiene habits) is the main breeding ground for the bacteria that cause gum disease. Our main treatment goal is to remove as much of this plaque as possible from tooth and gum surfaces. Much of the plaque can be removed using special hand or ultrasonic instruments that deep clean dental surfaces, including the roots. But while effective, these manual techniques may not address the full extent of infection, especially if the disease is well advanced.

If severe bone loss has already occurred, deep pockets of infection may have developed. As bone loss progresses, teeth with multiple roots may also develop an anatomical problem known as furcation invasions where the roots of the tooth branch off. If there continues to be signs of disease, like gum inflammation, bleeding or pus formation, it’s these hard to reach areas that may still be a problem even after extensive treatment. If so, we may need to take a different approach with antimicrobial or antibiotic products.

The most effective antimicrobial substance for reducing bacteria in biofilm is a chlorhexidine mouthrinse. The typical 0.12% solution is only available by prescription — if taken for a prolonged time it can result in tooth staining, affected taste or mouth irritation. To assure the solution reaches below the gum line, it will need to be applied by us in the office, followed up flushing irrigation of the affected area.

Another alternative is topically applied antibiotics that can stop or even reverse the progression of gum disease. There’s evidence that topical applications can penetrate into these deeper areas of infection. A common antibiotic used in this way is tetracycline, which has been shown to stop inflammation and infection.

These treatments don’t eliminate the need for mechanical cleaning, and the prolonged use of antibacterial products can have a detrimental effect on “good” bacteria (needed, for example, to complete the digestive process). It will depend on the extent of the gum disease to determine how successful conservative treatment may be. It’s also important that you contribute to your own dental health with a renewed daily oral hygiene habit.